What are the sesamoids and what is sesamoiditis?
Sesamoid bones are the unique little bones around your big toe joint. They are cleverly connected to other bones inside two tendons called the flexor hallucis brevis (this muscle makes your toe point downward). There are two sesamoid bones. The one on the inside of the joint is called the “tibial sesamoid” and the outer one is called the “fibular sesamoid”. Sesamoiditis occurs when one or more of the sesamoides become inflammed.
What is sesamoiditis?
Sesamoiditis is a painful condition that affects the bottom of your foot. It occurs when the sesamoid(s) become inflamed, which can be caused by activities such as walking or running on hard surfaces, wearing poor-fitting shoes, and standing for long periods. Some foot types (like high arches) can cause more pressure to be placed through the sesamoid bones.
If you are experiencing any pain in your foot, it is important to see a doctor and rule out sesamoiditis. Sesamoiditis can be treated with conservative methods such as rest, ice, compression, and elevation (RICE). The most important treatment regimen that needs to be put in place is a way to reduce pressure on the bones. This is called offloading. Some ways to accomplish this would be through various types of pads placed onto the ball of the foot, orthotics (with a window cut out so the sesamoids “float”). In more significant cases with severe pain, a large fracture boot to immobilize the whole foot might be necessary.
To help prevent sesamoiditis from occurring in the first place, make sure you wear supportive shoes that fit well and aren’t too tight. When walking or running on hard surfaces, try to use shock-absorbing insoles in your shoes. And finally, take breaks often if you have to stand or walk long distances. Sesamoiditis can be a real pain!
When should I see a doctor?
If you are experiencing any pain in your foot, it is important to see a doctor and rule out sesamoiditis. Ways to check for sesamoiditis would be through a good physical exam, x-rays and sometimes an MRI is needed.
If you had an injury and then developed pain around the sesamoids, it is really important to see a doctor because it is also possible that your pain is due to a broken bone. This is treated differently.
What if my symptoms do not get better?
If your symptoms do not get better with the treatments mentioned above, you may have a sesamoid fracture. Sesamoid fractures are serious injuries and need to be seen by a foot and ankle specialist. Surgical treatment may sometimes be necessary for this type of injury if conservative methods fail.